Endocrine Abstracts

Background: Adrenal incidentalomas (AI) have an increasing prevalence during last decades, probably due to the extended use of new imaging techniques and longer life expectancy. Adrenal hormonal hypersecretion, even subclinical, is probably related to cardiovascular disease (CVD).

Methods: We evaluated 100 patients with adrenal masses, incidentally discovered in imaging techniques performed for non adrenal disorders (67 Female, 33 Male, mean 58.1±12.9 years, median 60.5y), according to NIH criteria of 2002 and ESE 2016. IDF 2006 criteria were used for metabolic syndrome (MS) definition.

Results: Mean incidentaloma size was 35.5±20 mm. 20% were bilateral, while 41% were located to the right and 39% to the left adrenal. The majority (70%) was found to be non functional and 30% to be functional. Autonomous cortisol secretion (ACS) was found in 15%, pheochromocytoma (Ph) in 7% and hyperaldosteronism (HA) in 8% of all cases. Non functioning lesions were defined as non functioning adenomas (62%), non malignant cysts (2%), myelolipomas (2%), metastases (1%) and bilateral teratoma (1%). MS prevalence was higher in study group compared with general population (65% vs 23%, P<0.001). There was no difference in MS prevalence between patients with functional and non functional tumors (63.3% vs 64.7%, P=0.53), while no difference was found between functional tumors (ACS60% vs Ph57% vs HA75%, P=0.78). Hypertension had the greatest proportion in cases with hyperaldosteronism, while no difference in central obesity, hyperlipidemia and abnormal glucose metabolism was found between functional tumors.

Conclusions: The prevalence of metabolic syndrome was found to be high in patients with AI. A common pathophysiologic pathway (probably hyperinsulinaemia) must be the underlying mechanism between AI and MS, associated with an increased risk for CVD.